scholarly journals Drug-Induced Interstitial Lung Disease after Anthracycline-Combined Chemotherapy for Breast Cancer: A Case Report and Literature Review

2021 ◽  
pp. 1671-1676
Author(s):  
Hideko Hoshina ◽  
Hiroyuki Takei
Keyword(s):  
Breast Cancer ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Interstitial Pneumonia ◽  
Triple Negative ◽  
Left Breast ◽  
Lymph Node Biopsy ◽  
Combined Chemotherapy ◽  
Drug Induced ◽  
Node Biopsy

Drug-induced interstitial lung disease (DILD) has been occasionally reported with various causative drugs. In the context of breast cancer, anthracycline infrequently causes pulmonary adverse events. We report a 67-year-old woman with cT2N0M0 triple-negative breast cancer who received neoadjuvant chemotherapy with anthracycline-combined chemotherapy with pegfilgrastim. She developed fever, cough, and shortness of breath after 21 days of the scheduled fourth cycle of anthracycline. Computed tomography revealed drug-induced interstitial pneumonia. Prednisolone (1 mg/kg) was administrated and gradually decreased. Thereby, interstitial pneumonia quickly improved. Partial resection of the left breast and sentinel lymph node biopsy were performed, and we diagnosed ypT1bN0. The patient received 4 cycles of taxane and hypofractional radiotherapy and survived without any recurrences over the following 37 months. We report a rare case of DILD due to anthracycline-combined chemotherapy. Twenty-five cases of DILD with breast cancer after administration of anthracycline have been reported so far. However, 14 cases occurred during taxane. Most of the cases had remission by steroid treatment. The patients with respiratory symptoms during chemotherapy should be suspicious of not only infection but also DILD.

scholarly journals Tuberculosis axillary lymph node coexistent breast cancer in adjuvant treatment: case report

2015 ◽  
Vol 13 (3) ◽  
pp. 423-425 ◽  
Author(s):  
Silvio Eduardo Bromberg ◽  
Paulo Gustavo Tenório do Amaral
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Adjuvant Treatment ◽  
Triple Negative ◽  
Ductal Carcinoma ◽  
Lymph Node Biopsy ◽  
Accurate Diagnosis ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Node Biopsy

Coexistence of breast cancer and tuberculosis is rare. In most cases, involvement by tuberculosis occurs in axillary lymph nodes. We report a case of a 43-years-old patient who had undergone adenomastectomy and left sentinel lymph node biopsy due to a triple negative ductal carcinoma. At the end of adjuvant treatment, the patient had an atypical lymph node in the left axilla. Lymph node was excised, and after laboratory analysis, the diagnosis was ganglion tuberculosis. The patient underwent treatment for primary tuberculosis. The development of these two pathologies can lead to problems in diagnosis and treatment. An accurate diagnosis is important to avoid unnecessary surgical procedures.

scholarly journals Sentinel Lymph Node Biopsy May Prevent Unnecessary Axillary Dissection in Patients with Inflammatory Breast Cancer Who Respond to Systemic Treatment

Breast Care ◽  
2020 ◽  
Vol 16 (5) ◽  
pp. 468-474
Author(s):  
Hasan Karanlik ◽  
Neslihan Cabioglu ◽  
Adela Luciana Oprea ◽  
Ilker Ozgur ◽  
Naziye Ak ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Axillary Dissection ◽  
Triple Negative ◽  
Systemic Treatment ◽  
Lymph Node Biopsy ◽  
Her2 Positive ◽  
Node Biopsy

Background and Objectives: Inflammatory breast cancer (IBC) is a rare and aggressive breast cancer treated up-front with systemic treatment. Both breast-conserving surgery and sentinel lymph node biopsy (SLNB) are controversial issues in the management of IBC. In this study, we aimed to assess the feasibility of SLNB in pathologically proven node-positive IBC patients. Methods: All patients with a histopathological diagnosis of IBC and biopsy-proven metastatic axillary lymph nodes underwent systemic treatment. Patients with a complete clinical response in the axilla who underwent SLNB followed by standard axillary dissection were analyzed. Results: The study consisted of 25 female patients. The identification rate (IR) and the false negativity rate (FNR) were 17/25 and 2/10, respectively. Overall, 9/25 and 7/25 of patients had a complete pathological response (pCR) in the breast and axilla after systemic treatment, respectively. Although the pCR in the axilla was 2/4 in nonluminal HER2-positive patients, the highest IR 4/4 and the lowest FNR 0/2 were determined in these patients. In triple-negative patients, however, the IR was 2/4 and the FNR was found to be 0/2. Conclusions: SLNB may be considered in selected axilla-downstaged IBC patients including patients with a pCR with HER2-positive and triple-negative tumors. Axillary dissection may be, therefore, omitted in those with negative SLNs.

scholarly journals Usual interstitial pneumonia: typical, possible, and “inconsistent” patterns

2017 ◽  
Vol 43 (5) ◽  
pp. 393-398 ◽  
Author(s):  
Pedro Paulo Teixeira e Silva Torres ◽  
Marcelo Fouad Rabahi ◽  
Maria Auxiliadora Carmo Moreira ◽  
Gustavo de Souza Portes Meirelles ◽  
Edson Marchiori
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Interstitial Pneumonia ◽  
Usual Interstitial Pneumonia ◽  
Connective Tissue Diseases ◽  
Drug Induced ◽  
Pictorial Essay ◽  
Clinical Differential Diagnosis ◽  
Current Guidelines ◽  
Ct Studies

ABSTRACT Idiopathic pulmonary fibrosis is a severe and progressive chronic fibrosing interstitial lung disease, a definitive diagnosis being established by specific combinations of clinical, radiological, and pathological findings. According to current international guidelines, HRCT plays a key role in establishing a diagnosis of usual interstitial pneumonia (UIP). Current guidelines describe three UIP patterns based on HRCT findings: a typical UIP pattern; a pattern designated “possible UIP”; and a pattern designated “inconsistent with UIP”, each pattern having important diagnostic implications. A typical UIP pattern on HRCT is highly accurate for the presence of histopathological UIP, being currently considered to be diagnostic of UIP. The remaining patterns require further diagnostic investigation. Other known causes of a UIP pattern include drug-induced interstitial lung disease, chronic hypersensitivity pneumonitis, occupational diseases (e.g., asbestosis), and connective tissue diseases, all of which should be included in the clinical differential diagnosis. Given the importance of CT studies in establishing a diagnosis and the possibility of interobserver variability, the objective of this pictorial essay was to illustrate all three UIP patterns on HRCT.

scholarly journals Prospective Study of Drug-induced Interstitial Lung Disease in Advanced Breast Cancer Patients Receiving Everolimus Plus Exemestane

2019 ◽  
Vol 14 (4) ◽  
pp. 441-451 ◽  
Author(s):  
Annelieke E. C. A. B. Willemsen ◽  
Jolien Tol ◽  
Nielka P. van Erp ◽  
Marianne A. Jonker ◽  
Maaike de Boer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Interstitial Lung Disease ◽  
Prospective Study ◽  
Advanced Breast Cancer ◽  
Lung Disease ◽  
Cancer Patients ◽  
Advanced Breast ◽  
Breast Cancer Patients ◽  
Drug Induced

scholarly journals Nonspecific interstitial pneumonia: A rare adverse reaction of atorvastatin

2018 ◽  
Vol 5 (4) ◽  
pp. 16
Author(s):  
Jack Xu ◽  
Steven Verga ◽  
Jonathan Stoll ◽  
Lauren Pioppo ◽  
Eileen Shanahan ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Statin Therapy ◽  
Interstitial Pneumonia ◽  
Case Series ◽  
Pulmonary Complications ◽  
Drug Induced ◽  
Cardiovascular Morbidity And Mortality ◽  
Nonspecific Interstitial Pneumonia ◽  
Coa Reductase

Introduction: Statins have been shown to effectively prevent both cardiovascular morbidity and mortality by inhibiting the hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase enzyme. Pulmonary complications are very rare, and can include pneumonitis, pleural effusion, and nonspecific interstitial pneumonia (NSIP). There have been very few previously documented cases of statin-induced fibrotic NSIP.Case report: We present a female with a history of hyperlipidemia on atorvastatin who presented with shortness of breath. Computed tomography scan of the chest revealed interstitial infiltrates with bilateral ground-glass opacities. She underwent a surgical lung biopsy which showed uniform fibrous alveolar septal thickening, scattered collections of alveolar macrophages and inflammation, along with areas of fibrosis. The findings were most suggestive of fibrotic NSIP. Atorvastatin was stopped and she was started on mycophenolic acid with improvement of her symptoms.Discussion: Although rare, the clinician should be aware of possible pulmonary complications of statin therapy. The exact mechanism of injury is unclear, however immunological or toxicological mechanisms are implicated. One case series of statin induced interstitial lung disease showed some improvement of dyspnea with systemic glucocorticoids and termination of statin therapy. Statins, specifically pravastatin, lovastatin, and simvastatin have been associated with drug induced pneumonitis and interstitial lung disease.

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